BACKGROUND:Currently, it is stil controversial about the border, surrounding fascia, space of pelvic cavity, distribution of nerves and lymph nodes of the mesorectum, and the development of new technologies makes a progress in related anatomic research.
OBJECTIVE:To summarize the previous studies so as to describe clearly the progress of mesorectal anatomy and to discuss its clinical value.
METHODS: Using “rectum; mesentery; fascia; space; nerve; lymph node; total mesorectal excision (TME); clinical anatomy” as key words, a computer-based search of PubMed was done for articles related to the mesorectum and surrounding fasciae, space of pelvic cavity, distribution of nerves and lymph nodes.
RESULTS AND CONCLUSION:Fresh or frozen specimens are often used for studying the mesenterium, fascia, nerves and lymph nodes by using traditional pelvic and perineum anatomical methods. Computer-assisted anatomical dissection can combine immunostaining with computer imaging. A three-dimensional model can wel reflect the relationship among the different anatomical structures, as wel as nerve traveling and spatial location. Mesorectum is located behind the denonviliers and in the front of the sacral fascia of the rectum. Pelvic splanchnic nerve of the mesorectum is derived from the anterior sacral nerve root, runs through the presacral fascia, and enters into the neuro-fascial layervia the pesacral space, which is divided into the upper and lower parts according to the peritoneum. There are more folds in the rear of lymph nodes within the mesorectum within and near the peritoneum. There are stil a lot of controversies about anatomical relationship between the mesorectum and surrounding structures, and to elaborate these issues can provide an objective basis for guiding clinical work.

BACKGROUND:The pelvic nerves innervate the pelvic viscera as wel as bring sensory information to the central nerve system, including splanchnic nerves and spinal nerves. Each of them comprises both motor fibers and sensitive fibers. Mostly, the key part of splanchnic plexus is pelvic plexus. Total mesorectal excision proposed by Heald in 1982 has been the “gold standard” for diagnosis and treatment of colorectal cancer. However, it carries a high risk of nerve damage during surgery, which results in urinary retention, sexual dysfunction and other complications. OBJECTIVE:To summarize the former researches so as to get a precise understanding of the pelvic fascia and nerve structure. METHODS:Using “splanchnic nerves, superior hypogastric plexus, pelvic plexus, pelvic splanchnic nerve, total mesorectal excision (TME), clinical anatomy” as key words, a computer-based search of PubMed was done for articles related to the pelvic nerves, including its pathway, consistent, ganglia, and reflection in pelvic viscera, published from 2000 to 2015. RESULTS AND CONCLUSION:The main splanchnic plexus in the pelvic cavity includes superior hypogastric plexus (it is located in the triangle formed by left and right common iliac artery and the sacral promontory), and pelvic plexus (hypogastric nerve, pelvic splanchnic nerve and sacral splanchnic nerve converge at the bottom of rectum, formed pelvic plexus, also known as the inferior hypogastric plexus). It is flattened against the lateral aspect of the rectum, the dorso-lateral bladder wal and the seminal vesicles. Nerves come from the plexus contain the sympathetic nerve, parasympathetic nerve and sensory nerve. They are in charge of the motions and sensations of the pelvic organs. The definite knowledge on the anatomy of pelvic fascia and nerve structures can avoid nerve damage during operation, which can help to improve the life quality of patients.

Objective To investigate the effect of clearing away heat and activating blood decoctions on salivary gland function of patients with Sj?gren's Syndromes (SS). Methods 24 cases of SS (SS group) and 7 cases of normal control (normal group) were tested with salivary gland scintigraphy using 99mTCO4-, and 11 cases of patients were re-tested after treatment. Results The introjection fraction (IF) of salivary gland had no statistical difference between the two groups, while the evacuation fraction (EF) was lower in SS group than in normal group (P

OBJECTIVE:To provide a reference for clinical use of anti-tumor adjuvant drugs as is reasonable,effective and economical. METHODS:By retrospective investigation and analysis,the utilization of anti-tumor adjuvant drugs in the oncology department of our hospital during 2010 and 2013 was analyzed statistically in respect of the type,dosage form,consumption amount,DDDs,DDC,DUI etc. RESULTS:The anti-tumor adjuvant drugs in our hospital were dominated by injections,especial-ly domestic drugs,the consumption amount of which accounted for 80% of the total consumption amount of anti-tumor adjuvant drugs each year. The anti-tumor adjuvant drugs were mainly used for symptomatic treatment of various adverse reactions. Drug syn-chronization was relatively good each year,however,excessive use of individual drugs existed. CONCLUSIONS:Anti-tumor adju-vant drugs have relatively better synchronism in the drugs quantities and medication number. However,individual drugs have exces-sive use and other irrational use.

Lurasidone is a new atypical antipsychotic drug, it was approved by the Food and Drug Administration ( FDA ) for treatment of schizophrenia on october 28,2010.The article is to provide an review about pharmacological effects, clinical applications, pharmacokinetics, dosage, drug interactions, adverse reactions of Lurasidone.

Objective:To evaluate the effect of nicastrin (nct) gene on the biological functions of melanocytes in zebrafish.Methods:By using a morpholino oligonucleotide (MO) technology, a nct-MO sequence targeting the zebrafish nct mRNA was designed, so was a MO control (ctrl-MO) sequence. Then, the enhanced green fluorescent protein (EGFP) mRNA with MO target sequence at its 5′ end was synthesized, and co-microinjected with the nct-MO or ctrl-MO sequence into the zebrafish embryos to verify the silencing efficiency of nct-MO and observe changes in developmental phenotypes in zebrafish. With wild-type zebrafish as a blank control group, real-time fluorescence-based quantitative PCR (RT-PCR) was conducted to determine the mRNA expression of melanin synthesis-and notch signaling pathway-related genes, including mitfa, tyr, tyrp1a, tyrp1b, dct, pmela, notch1a, notch1b and hey1 genes. One-way analysis of variance was used for the comparison of means among multiple groups, and least significant difference (LSD) - t test for multiple comparisons. Results:Eight hours after zebrafish fertilization, green fluorescence was observed in the zebrafish embryos in the ctrl-MO+EGFP mRNA group, but not in the nct-MO+EGFP mRNA group or blank control group. Forty-eight hours after fertilization, the proportion of pigmented area among the whole area of the tail of zebrafish larvae was significantly lower in the nct-MO group (0.169 ± 0.083) than in the ctrl-MO group (0.258 ± 0.042, t=3.202, P=0.005) , and disorderly pigment distribution in the tails was observed in the nct-MO group. RT-PCR revealed significant differences in the mRNA expression of pmela, tyrp1a and hey1 genes among the nct-MO group, ctrl-MO group and blank control group (all P < 0.05) , but no significant difference was observed in the mRNA expression of mitfa, tyr, tyrp1b, dct, notch1a or notch1b genes among the 3 groups (all P>0.05) ; the relative expression levels of pmela and tyrp1a mRNAs were significantly lower in the nct-MO group (0.708 ± 0.028, 0.558 ± 0.136, respectively) than in the ctrl-MO group (1.023 ± 0.142, 1.016 ± 0.134, respectively, both P < 0.05) . Conclusion:The nct gene may affect biological functions of melanocytes by regulating melanin synthesis in zebrafish.

BACKGROUNDCorrect diagnosis is very important to patients with suspected lung cancer. According to the higher ¹⁸F-FDG intake of tumor tissues much more than normal tissues, this study evaluates the clinical value of ¹⁸F-FDG dual-head coincidence SPECT/CT in diagnosis of lung cancer.

METHODSSixty-one patients with lung mass underwent ¹⁸F-FDG dual-head coincidence SPECT/CT imaging and thoracic CT imaging before operation. These imageological results were compared with histological examination of lung mass.

RESULTSThe sensitivity, specificity and accuracy of ¹⁸F-FDG-SPECT/CT in differentiating malignant and benign lesions were 82%, 87%, 84%, respectively. Compared with thoracic CT imaging, diagnostic rate of mediastinal lymphatic metastasis was significantly higher by ¹⁸F-FDG-SPECT/CT (52% vs 81%, P < 0.05) .

CONCLUSIONSCombined functional-anatomical image of ¹⁸F-FDG-SPECT/CT has potential to improve staging and localizing procedures of lung cancer. It is an excellent modality in diagnosis and differential diagnosis of lung cancer.

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.

Objective To assess the incidence,clinic feature,pathological characteristics and prognosis of incidental prostate cancer from specimens via radical cystoprostatectomy (RCP) for muscleinvasive bladder cancer.The postoperative erectile function in patients with NVB operation are also to be evaluated.Methods Between Jan 2002 and Jan 2015,150 male patients with bladder cancer who underwent radical cystoprostatectomy in our center were included in this study.133 patients underwent open surgery and 17 cases underwent laparoscopic operation (13 patients underwent NVB operation).The average age of 150 patients was 63 years (ranging 41 to 83 years).The average tPSA was 3 ng/ml(ranging 0.2 to 7.8 ng/ml).The digital rectal examination was negative,CT results didnt exhibit the evident of abnormality in prostate.Results Overall,incidental prostate cancer was diagnosed in 11 male patients (7.3％).The pathological diagnosis are all prostatic adenocarcinoma.In those patients,the mean age was 65.5 years (ranging 42 to 82 years).The mean tPSA at the time of surgery was 2.6 ng/ml (0.3-4.0 ng/ml).There was no statistical significance of tPSA values in the incidental prostate cancer group and non risk group (2.6vs.3.2ng/ml)(P ＞ 0.05).The preoperative enhanced CT imaging showed normal prostate in 7 cases,prostate hyperplasia in 2 cases,prostate calcification in 1 cases and bladder cancer invasion into the prostate in 1 cases.9 cases of incidental prostate cancer are low risk grade (Gleason score ≤ 6,the clinical stage ≤T2).Among 11 cases,bladder cancer histologic type in 10 cases was transitional cell carcinoma and small cell carcinoma in 1 case.According to the TNM classification,4 cases were less than pT2 stage and 7 cases were more than pT3 stage.11 patients were followed up between 6 to 24 months (mean 10 months).All patient survived at the end of study without the treatment of castration.Among 13 cases accepted NVB operation,8 cases achieve the preoperative level of erectile function to achieve.Conclusions The rate of incidental prostate cancer from RCP specimens is low,Most patients have low risk level,and there was no statistical significance of tPSA values between the incidental prostate cancer group and non risk group.

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